Carbapenemase-producing Enterobacteriaceae in a group of Polish travelers returning from South and South-East Asia, June 2017 – June 2018. Environment- or healthcare-associated?

Abstract

Introduction Carbapenemase-producing Enterobacteriaceae have spread rapidly through the countries and continents to become a global concern. One of the main reservoirs of NDM-1 positive strains from the Enterobacteriaceae family is the Indian subcontinent (Bangladesh, Pakistan, India). Material and methods During June 2017 – June 2018, rectal swab samples were collected routinely in all patients returning to Poland from South and South-East Asia. During molecular examinations gene bla NDM-1 encoding NDM-1 carbapenemase was detected. Results 31 patients were examined after returning to Poland from a trip to South and South-East Asia. The presence of New Delhi Metallo-β-lactamase-1 producing Escherichia coli and Klebsiella pneumoniae was confirmed in three patients (9.7%) returning to Poland from travels to India. All the positive patients were hospitalized during the trip in a New Delhi hospital. Conclusions Digestive tract carriage of NDM in a group of Polish travelers is a significant health and epidemiological problem. The study confirms the necessity for screening for carbapenemase-producing Enterobacteriaceae (CPE), particularly among travellers. Rectal swabs should be collected in every case of patients returning from international trips, and the possibility of environment-associated infections should be emphasized.

Keywords

• carbapenemase
• carbapenems
• New Delhi Metallo-β-lactamase
• NDM
• CPE
• travelers’ diarrhea